Pulmonary infiltrates in neutropenic patients with acute leukemia during chemotherapy: outcome and prognostic factors

STUDY OBJECTIVE: To determine predictors of mortality from pulmonary infiltrates in neutropenic patients with acute leukemia during chemotherapy, and the significance of those factors related to the underlying malignancy and its therapy as well as of those related to the severity of the illness associated with pulmonary infiltrates. DESIGN: A historical cohort study. SETTING: A university teaching hospital and tertiary referral center. PATIENTS AND METHODS: Overall, 53 patients with neutropenia during chemotherapy and with first episodes of pulmonary infiltrates during a 4-year period were studied. Prognostic analysis included 38 variables. Multivariate analyses were performed by logistic regression. RESULTS: The survival rate from pneumonia was 57% (30/53). The following eight parameters were significantly associated with death in univariate analysis: comorbidity present; development of "late" pulmonary infiltrates (> or = 14 days after hospital admission); heart rate > or = 100 beats/min; a ratio heart rate/systolic blood pressure (HR/SBP) > or = 1.2; urea nitrogen > 7 mmol/L; radiographic score > or = 3; neutropenia < 1.0x10(9)/L at the treatment end point; and failed complete remission. In a multivariate model including only parameters available at diagnosis of pulmonary infiltrates, the presence of a ratio HR/SBP > or = 1.2 and of a radiographic score > or = 3 remained independently associated with death. In a second model also including the evolutionary parameter neutropenia < or = 1.0x10(9)/L at the treatment end point, both parameters remained significant together with neutropenia <1.0x 10(9)/L at the treatment end point. The presence of a ratio HR/SBP > or = 1.2 was a strong marker of early death. CONCLUSION: Both therapy- and malignancy-associated neutropenia as well as the severity of illness associated with pulmonary infiltrates are independent prognostic factors. Patients with a ratio HR/SBP > or = 1.2 at diagnosis of pulmonary infiltrates suffer from potentially reversible acute illness, are at risk for early death and, therefore, may be appropriate candidates for treatment in an ICU.     

The artificial heart and neuromonitoring? Technical and clinical aspects

There is a steady progress in the development of artificial heart and circulatory assist devices. There is also no doubt that further advances in energy systems, materials, and electronics will provide for smaller and more reliable electrically driven blood pumps, but the present engineering design appears to be adequate to provide devices satisfactory for initial clinical use. Due to problems in the availability of suitable donor hearts, the concept of replacing the natural heart with an artificial heart as a "bridge to transplantation" has gained attention in recent years. The present paper shows technical and clinical aspects of multivariable electrophysiologic neuromonitoring in a patient with an artificial heart assist device in the intensive care unit. The data (EEG, 40 Hz brain oscillations, brainstem auditory- and somatosensory evoked potentials) are discussed with respect to the influence of the artificial heart on their quality and reliability. Reasons for artifacts and problems of interpretation are shown.     

Knowledge search and people with high epistemic curiosity

Porter sites have tried to increase their business potentials by helping users easily engage in diverse online activities such as search, entertainment, online communities, and others. Knowledge search engine is one of the most successful killer applications increasing user loyalty. However, most studies have independently focused on search engine technology such as search keyword algorithm, presentation of information and user characteristics such as cognitive style, search experiences, and skill levels. However, these previous studies lack an integrated understanding of causal links among critical factors predicting user motives and intention involving more situation-specific user characteristics. To fill these gaps in the literature, the present study focuses on whether knowledge characteristics such as specialization, preciseness, and diversity, and system characteristics such as interactivity, responsiveness, and communication richness are important in forming user motives and intention. The present study also identifies a moderating role of epistemic curiosity in the links between motives and intention. Two hundred and fifty-five data from Korean university students confirmed that knowledge and services characteristics such as specialty, preciseness, diversity, communication richness improve user motives, which have a positive impact on intention. Epistemic curiosity has a moderating effect on the links between motives and intention. Theoretical and practical implications are discussed in conclusion.     

Improving traversability of quadruped walking robots using body movement in 3D rough terrains

This paper presents a study on improving the traversability of a quadruped walking robot in 3D rough terrains. The key idea is to exploit body movement of the robot. The position and orientation of the robot are systematically adjusted and the possibility of finding a valid foothold for the next swing is maximized, which makes the robot have more chances to overcome the rough terrains. In addition, a foothold search algorithm that provides the valid foothold while maintaining a high traversability of the robot, is investigated and a gait selection algorithm is developed to help the robot avoid deadlock situations. To explain the algorithms, new concepts such as reachable area, stable area, potential search direction, and complementary kinematic margin are introduced, and the effectiveness of the algorithms is validated via simulations and experiments.     

A hybrid observer for characterization and compensation of periodic disturbances

Usage of frequency based error correction methods for repetitive disturbances becomes popular in data storage devices that use a rotating mechanical power plant. Two distinct disturbance cancellation methods, disturbance observer (DOB) and adaptive feed forward control (AFC) are the most popular approaches used for current drive servo integration. DOB reduces error using a predetermined function that is calculated thorough a complicated process. Generally the response to disturbance and initiation of control action of DOB is relatively fast even if the amount of error reduction is limited. Meanwhile the error elimination capability of AFC for the repetitive disturbance is normally better than DOB as it utilizes a Fourier coefficients updating feature that supports an enhanced fine adaptation of a certain frequency disturbance. Of course, AFC suffers for disturbances that have neighboring close frequencies due to the inherent fundamental frequency dependencies of AFC formulation. In the present work, an attempt for combining benefits of AFC and DOB is made. This might enables control action not only to generate fast response to disturbance but also perform an accurate error rejection. This feature also provides to the closed loop system a frequency selection for enabling a strategic selective error rejection. The proposed method named Hybrid Disturbance Observer (HDOB) is compared to the traditional AFC and DOB.     

Magnetic landmark-based position correction technique for mobile robots with hall sensors

We propose a precise position error compensation and low-cost relative localization method in structured environments using magnetic landmarks and hall sensors. The proposed methodology can solve the problem of fine localization as well as global localization by tacking landmarks or by utilizing various patterns of magnetic landmark arrangement. In this paper, we consider two patterns of implanted permanent magnets on the surface, namely, at each vertex of regular triangles or rectangles on a flat surface. We show that the rectangular configuration of the permanent magnetic bars is better for a robust localization under sensor noise. For the experiments, permanent magnet sets in rectangular configuration are placed on the floor as landmarks at regular intervals, and magnetic hall sensors are installed at the bottom of a mobile robot. In our implementation, the accuracy after the error compensation is less than 1 mm in the position and less than 1° in the orientation. Due to the low cost and accuracy of the proposed methodology, it would be one of the practical solutions to the pose error correction of a mobile robot in structured environments.     

Decentralised sampled-data control for large-scale systems with nonlinear interconnections

This paper presents a decentralised sampled-data control technique for a class of large-scale systems, which are considered to consist of linear subsystems and nonlinear interconnections. The decentralised sampled-data controller design problem is established using a closed-loop subsystem. Based on the controller design problem, the stability condition is derived for a closed-loop large-scale system, and the maximum interconnection bound is guaranteed to satisfy the stability condition. Also, its sufficient condition is formulated in terms of linear matrix inequalities. Finally, the effectiveness of the proposed technique is verified by using an example of the multi-machine power system.     

Output feedback regulation of upper triangular nonlinear systems with uncertain time‐varying delays in states and input

In this paper, an output feedback controller is studied to regulate a class of upper triangular nonlinear systems with uncertain time‐varying delays. The key features of our considered system are that there are uncertain time‐varying delays in both states and input and the high‐order nonlinearity is in a more relaxed form over the previous results. Theoretical analysis and numerical example are presented to show the benefits of our controller. Copyright © 2017 John Wiley & Sons, Ltd.     

Proteinase activity in the isolates of Trichomonas vaginalis according to their pathogenicity

Ten axenic isolates of Trichomonas vaginalis were subcutaneously injected to the BALB/c mice in order to assess their pathogenicity by means of so-called "mouse assay" method. All the isolates revealed neutral and acid proteinase activities both in their lysates and in culture media, but the specific activities of both proteinases in the severely pathogenic group were significantly higher than the mildly pathogenic group (p < 0.05). In the SDS-PAGE system in which the electrophoretic gels contained 0.4% gelatin as the substrate, five different banding patterns of trichomonal proteinases were detected, and the patterns were closely related with the pathogenicity of the isolates of T. vaginalis. All five bands might be regarded as cysteine proteinases group in the inhibitor assays. The cytotoxicity of the lysates of T. vaginalis to the target Chinese hamster ovarian (CHO) cell line was also significantly different according to the pathogenicity of the isolates, and generally lower in the lysates treated with cysteine proteinase inhibitors than in the control lysates. In summarizing the results, it might be considered that the proteinases of T. vaginalis showing five electrophoretic banding patterns are closely related with the pathogenicity and cytotoxicity of the isolates of T. vaginalis.     

Sequence-based differentiation of strains in the Mycobacterium avium complex

The complete 16S-23S rDNA internal transcribed spacer (ITS) was sequenced in 35 reference strains of the Mycobacterium avium complex. Twelve distinct ITS sequences were obtained, each of which defined a "sequevar"; a sequevar consists of the strain or strains which have a particular sequence. ITS sequences were identified which corresponded to M. avium (16 strains, four ITS sequevars) and Mycobacterium intracellulare (12 strains, one ITS sequevars). The other seven M. avium complex strains had ITS sequences which varied greatly from those of M. avium and M. intracellulare and from each other. The 16S-23S rDNA ITS was much more variable than 16S rDNA, which is widely used for genus and species identification. Phylogenetic trees based on the ITS were compatible with those based on 16S rDNA but were more detailed and had longer branches. The results of ITS sequencing were consistent with the results of hybridization with M. avium and M. intracellulare probes (Gen-Probe) for 30 of 31 strains tested. Serologic testing correlated poorly with ITS sequencing. Strains with the same sequence were different serovars, and those of the same serovar had different sequences. Sequencing of the 16S-23S rDNA ITS should be useful for species and strain differentiation for a wide variety of bacteria and should be applicable to studies of epidemiology, diagnosis, virulence, and taxonomy.